Suppressed thyroid & Operation

[MissFG]

Need advise please...

I have an upcoming operation and following my pre-op they have written to my GP.

As my TSH is suppressed <0.01 and FT3 is in range the anaesthetist has contacted an endocrinologist whose advised to reduce my T3 from 50mcg to 45mcg.

Has anyone else had any issues with operations and anaesthetic? I can reduce to 45 but it’s not easy with 25mcg pills plus I’ll probably feel tired. And I’m in range?!

How long does FT3 take to show up in bloods? If I reduce a week before the test and get retested. And maybe keep it that low til after operation but it could take weeks to get a date?

I’m really not sure what to do.

Just found an article and I didn’t realise a suppressed TSH is considered very risky in surgery:

In general, the classification of “severely hypothyroid” includes those patients with myxedema coma or severe complications such as altered mentation, pericardial effusions or heart failure, or very low levels of thyroxine (<1 µg/dL). Based on the lack of outcomes data and an understanding of the risks outlined above, nonemergent surgery should be postponed until the hypothyroidism has been treated. If emergent surgery is required, thyroid hormone levels should be normalized as rapidly as possible, using IV levothyroxine in a loading dose of 200 to 500 µg followed by 50 to 100 µg IV daily.21 Simultaneous administration of IV liothyronine should be considered if there is suspicion for myxedema coma. If there is any suspicion for concurrent adrenal insufficiency, glucocorticoids should be administered in stress doses prior to or together with thyroid hormone.

ncbi.nlm.nih.gov/pmc/articl...

[SlowDragon Administrator]

Well if anaesthetist what’s TSH not suppressed....that’s highly unlikely on T3

Suggest you try to have discussion direct.

Perhaps give copies of recent TSH, Ft4 and ft3 results

[MissFG in reply to SlowDragon]

They’ve access to all my records so see I’ve reduced it to get in range for my last bloods. If they don’t want my TSH suppressed to operate then I don’t know what they’ll do.

[Lora7again]

Discuss this with the surgeon before your operation. That will make them monitor you carefully during the operation. I would not change your medication because that could cause more problems. I have posted on your other thread btw.